| NPI | 1609963404 |
|---|---|
| Former Name | MINDY MARLENE PORTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60128119) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA RC00053309) |
| 101Y00000X Counselor (Licence: WA LH60128119) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2013-02-05 |